Wiki Hospitalized 12/2017 with one insurance, still in hospital 1/2018 with new insurance

Create Wiki
M

MarylouT

Guest
Messages
33
Best answers
0
I would appreciate any advice on this - A patient was admitted to the hospital 12/29/2017 with Medicare A&B only. On 1/1/2018, while still hospitalized, patient's insurance changed to a Medicare Advantage Plan. For the January hospital visits by our physicians, do I still use her Medicare or switch to her Medicare Advantage insurance? Thanks!!
 
Any services performed would go under the admit date so that insurance would be billed. Any new providers that see the patient bill by DOS, so those would go to whatever insurance is current.
 
terrilynn.logan@gmail.com said:
Any services performed would go under the admit date so that insurance would be billed. Any new providers that see the patient bill by DOS, so those would go to whatever insurance is current.
Click to expand...

Thank you for your advice. We bill under our corporate NPI, so even if a different physician has seen the patient after the insurance change, based on your advice, we should still bill all services by our physicians for this particular hospitalization under the patient's Medicare, not her new Medicare Advantage plan. Am I understanding that correctly?
 
For the physician (Part B) billing, you bill whatever insurance the patient had at the date of the visit. So 2017 DOS = MCR; 2018 DOS = MCR advantage. The other post was providing additional helpful information regarding FACILITY billing, which is done by admit date, so MCR only.
 
cms@islandoncology.com said:
For the physician (Part B) billing, you bill whatever insurance the patient had at the date of the visit. So 2017 DOS = MCR; 2018 DOS = MCR advantage. The other post was providing additional helpful information regarding FACILITY billing, which is done by admit date, so MCR only.
Click to expand...

Thank you very much!
 
You must log in or register to reply here.
Top